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Michigan Medicaid - MDHHSMedicaid · Billing Codes · Claims & Billing · MI · Oral & Maxillofacial Surgery, Podiatry, AnesthesiologyMedium impact

MMP 26-15: Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) Code Updates

Act
by Apr 1, 2026
Effective date
Apr 1, 2026
Identified
Jun 16, 2026

Summary

Michigan Medicaid has updated CPT and HCPCS codes effective April 1, 2026, adding new covered codes for various provider types and discontinuing several existing codes. The policy also includes retroactive coverage for some codes back to January 1, 2026.

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What to do

by Apr 1, 2026 · 3 steps
01Billing team must update system with new covered codes for Michigan Medicaid patients and stop billing discontinued codes C9145, C9307, C9308, L6000, L6010, and L6020 after March 31, 2026.
02Verify prior authorization requirements for codes marked with asterisk (J3404, A6548, 0473U, L6028).
03Update billing software to accept new codes for appropriate provider types and check CHAMPS system for coverage parameters.

Codes mentioned

A2040A2041A2042A2043A2045J0463J1164J1553J3404J8502J9003J9183J9277J9278J9601Q4418Q4419Q4421Q4422Q4423Q4424Q4425Q4426Q4427Q4428Q4429Q4435Q4436Q4437Q4438Q4439Q4440Q5161Q5162A6548A9616J9161J9275L6028D9244D9245C9145C9307C9308L6000L6010L6020

Original notice

MMP 26-15: Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) Code Updates
michigan.gov · Always check the source before changing claims.
View original ↗

Related changes

See all Michigan Medicaid - MDHHS changes →
MMP 26-31: Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) Code UpdatesHighEffective Jul 1, 2026 · Claims & BillingMSA 17-01MediumEffective Jan 1, 2017 · Provider BulletinMSA 17-30MediumEffective Jul 1, 2017 · Provider BulletinMSA 20-01MediumEffective Jan 1, 2020 · Provider BulletinBrowse every Michigan Medicaid - MDHHS change in the policy list

Related policy hubs

Michigan Medicaid - MDHHS policiesMI policy changesOral & Maxillofacial SurgeryPodiatryAnesthesiologyCode A2040Code A2041Code A2042Code A2043Code A2045Code J0463Code J1164Code J1553Code J3404Code J8502Code J9003Code J9183Code J9277Code J9278Code J9601Code Q4418Code Q4419Code Q4421Code Q4422Code Q4423Code Q4424Code Q4425Code Q4426Code Q4427Code Q4428Code Q4429Code Q4435Code Q4436Code Q4437Code Q4438Code Q4439Code Q4440Code Q5161Code Q5162Code A6548Code A9616Code J9161Code J9275Code L6028Code D9244Code D9245Code C9145Code C9307Code C9308Code L6000Code L6010Code L6020

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